[Ip-health] Eyeing Coverage: Ontario Blinks Over Lucentis

[Joana Ramos]

http://www.pharmalot.com/2008/03/eyeing-coverage-ontario-blinks-over-lucent=
is/#more-12522

Eyeing Coverage: Ontario Blinks Over Lucentis
March 14th, 2008 8:25 am By Ed Silverman
Pharmalot

In a surprise move, the Ontario government announced yesterday it will
begin covering the cost of an expensive drug to treat macular
degeneration, a leading cause of blindness, even though an alternative
is widely available at a fraction of the cost, The Globe and Mail reports.

It will cost the province=92s drug benefit plan roughly $100 million over
the next three years to pay for Lucentis, a breakthrough drug that has
been on the Canadian market since last September. The decision will give
eligible Ontarians - primarily seniors - suffering from wet macular
degeneration access to this new drug for the first time, the province=92s
Ministry of Health and Long-Term Care said in a statement. But the paper
reports thousands of Canadians already have access to a similar drug
that is much cheaper than Lucentis and that many ophthalmologists say is
equally effective. That drug, Avastin, and Lucentis, are both made by
Genentech.

The problem is that Avastin was developed to fight colorectal cancer and
isn=92t approved for use in the eye by Health Canada. Although many
ophthalmologists in Canada regularly use Avastin to treat wet macular
degeneration, the fact it doesn=92t have government approval gives
significant leverage to Novartis, which sells Lucentis in Canada, to
lobby governments to fund the high-priced drug.

=93It=92s a very unusual situation,=94 said Keith Gordon, head of research =
at
the Canadian National Institute for the Blind. The situation is similar
to what took place in the US, which you can read about here.

The Common Drug Review, a federal body that recommends whether provinces
should pay for certain drugs, has already rejected one request to
recommend coverage for Lucentis. Novartis has asked the body to
reconsider the issue, and a final decision is expected later this month.
Despite the existence of the CDR, provinces retain the freedom to decide
whether certain drugs merit coverage.

Ontario decided to give Lucentis a priority review and approved its
application because of the compelling evidence of its benefits, Helen
Stevenson, assistant deputy minister and executive officer of Ontario
public drug programs in the province=92s health ministry, told the paper.
Quebec is the only other province that has decided to cover Lucentis.

But some health-policy experts are criticizing Ontario for choosing to
cover its cost despite the availability of Avastin. The decision will
boost the drugmaker=92s profits at the expense of Canadians, who stand to
benefit more from a cost-effective solution, says Arthur Schafer,
director of the University of Manitoba=92s Centre for Professional and
Applied Ethics.

=93There=92s no reason to prefer (Lucentis) to Avastin, aside from the fact
it has been tested and approved,=94 he tells the paper. =93Why would
Canadian provinces be profligate in this matter, allowing the drug
company really to suck out what will turn out to be tens or hundreds of
millions of dollars from our health-care system?=94

Instead of covering Lucentis, the government could fund research trials
to examine Avastin, Alan Cassels, a drug policy researcher at the
University of Victoria, tells the paper.

But that message may be lost on governments that hear compelling
evidence from advocacy groups and patients, who often receive money from
drugmakers to speak about a med, according to Schafer. For instance,
Novartis provided money to the CNIB, in the form of an unrestricted
educational grant, that is being used in part to fund its advocacy
campaign supporting Lucentis. Novartis also has several paid
ophthalmologists who promote the use of Lucentis.

But CNIB=92s Gordon defended accepting the grants, saying the funding
makes up less than 1 per cent of the association=92s budget. =93It really
doesn=92t influence what we do or how we do it,=94 he tells the paper. =93O=
ur
reason for being involved in this is more than half our clients have=94
age-related macular degeneration.

Source: The Globe and Mail

-------------
Joana Ramos, MSW
Cancer Resources & Advocacy
Seattle WA USA
+1-206-229-2420
http://ramoslink.info/
www.bmtbasics.org